How does The Choice-based childbirth trend impact obstetricians? That’s an interesting question. There’s a marriage between all doctors and patients/clients/consumers. While there are people who have lots of anger toward doctors and particularly obstetricians, the reality is that most people and pregnant women are perfectly fine with the care they receive. It’s simple. Obstetricians are highly skilled and almost no pregnant women or expectant fathers (unless they work as an obstetrician) have been to many birth. Just as people rely on car mechanics, teachers or dentists to know their stuff and do what is necessary, most pregnant women are absolutely fine following their obstetrician’s way of doing things.
When the US experienced the short lived Skills-based childbirth trend in the 1960s/70s everything change between expectant families and obstetricians. Curiously becoming skilled was broadly accepted. It didn’t take heaps of time or energy to learn a simple set of skills that could easily be used as any birth took place. Learning skills didn’t really require any investigation or decision making. You learn the skills, practice them and use them. Very direct.
But obstetricians were treated to an incredible revelation. Previous women did very little for themselves or if they did only they knew. Of course, some women figured out how to relax and use good breathing patterns but it was not part of ‘birth’ for anyone who wanted skills. Lamaze changed all that. Childbirth classes suddenly sprang up every where teaching women/men simple breathing and relaxation techniques (that were complexly and unnatural).
Perhaps in the first few years obstetricians might have thought it was all a phase or insignificant but over time seeing a large percent of your patients use skills had a phenomenal impact on obstetricians. Even the most rigid and hardened obstetricians were treated to seeing women intentionally cope and manage childbirth pain and consciously participate in the 2nd stage of birth. They saw fathers really engaged in helping the woman to navigate through the experience she was having.
Many an obstetrician began to negotiate standards of care with their clients. Women who wanted to try achieving a vaginal birth after a Caesarean still struggled individually but over time more women could ‘choose’ a trial of labor. Women who wanted to leave hospital shortly after birth were more likely to do that because they bounced right up after a few hours after the birth and could obviously go home. In fact everything became negotiable. This was totally new to obstetricians who were used to being in charge.
Some obstetricians welcomed the empowerment and helped families make choices. In other words, they used their experience to create a grey area rather than black and white approach to birth. In other words, if an individual woman went past her due date and didn’t want to be induced many obstetricians accepted this decision as long as there were no obvious reasons for an induction. Of course, there were and are still obstetricians who hold a narrow view but by and large, choices became a normal part of maternity care. Obstetricians were no longer the ring master. Instead they were part of an informal professional and consumer team.
But eventually the Choice-based childbirth trend began to look like a list of demands, a wish list, a check list from a menu and a defensive challenge. The Natural Birth (supporting the Midwifery Movement) became very, very vocal. This was great for many families yet also has led to the growth of shame, blame, guilt and disappointment around birth. This is partly due to the massage given by these dedicated women that skills were not essential thus precipitating the death of skills-base childbirth classes (still available in some places). This is also partly due to the hopeful yet misleading view of childbirth as being safe, easy with good outcome if you just remove it from medical care (of course, unless necessary but what did that mean?). And sadly, underlying both of these messages was an out and out anger toward and blame of obstetricians.
Let’s use our great Human Mind to imagine what might have happened had a Skills-based and Choice-based trend grown hand in hand instead. What might have happened if families had been told that skills might increase the chances their birth choices would unfold as wished OR that skills can be used alongside any type of medical care. We can actually imagine that childbirth would have become a more positive experience for the larger majority of families had skills and choices worked together.
Because this didn’t happen when the Choice-based trend took over, obstetricians saw fewer and fewer skilled mothers/fathers and more very demanding and unrealistic Birth Plans. Without a doubt this has played into the oppositional tension in childbirth today. While choices have worked well for a very small percent of women, by in large the Choice-based trend has not achieved the goals and left many, many, many women feeling their have failed or their obstetricians has failed them.
Obstetricians have just switched off from the Choice-based approach because they see so many Birth Plans fail. It’s quite sad really. This might have been prevented had the value of birth and coaching skills been really acknowledged and the Skills-based approach been encouraged to evolve. The Pink Kit thankfully was the evolution of skills and that will be discussed in a future post.
But its sadder in what its done to obstetricians. Over the recent years maternity care has become much more technical with a loss of hands-on skills. Curiously while this is happening in maternity care it’s going in a different direction in other areas of health care. People with all sorts of health issues are increasingly encouraged to change their life style (learn new skills from exercise to cooking from stress reduction to natural remedies)
Growing a Skills-based childbirth trend is NOT about pleasing obstetricians. It’s all about us as expectant parents. But most families will be attended in the US by obstetricians and often be referred to an obstetrician in other countries. It would be great to have obstetricians become part of the Skills-based approach to pregnancy and birth. They can encourage their patient/clients to learn skills for their baby’s birth. And it takes no effort at all for any obstetrician to invite families to use their birth and coaching skills as their baby’s birth unfolds.
NEXT POST: HOW MANY CHOICES – FEW SKILLS FAILS MIDWIVES
Here’s a link. This link will be put on all the posts. Kristen has 6 kids, the last 3 are PK babies. She KNOWS about birth and is one of our affiliates. That means if you purchase The Pink Kit through her she gets a commission. Her husband Scott’s first baby was a Pink Kit experience. He’ll explain how The Pink Kit made certain he was able to become a skilled birth coach to a woman who had previously had three great births.!
Kristen’s written a time-line calendar for use of The Pink Kit. You just need to sign up to her mail list (we don’t keep a mail list) and she’ll send you the Time Line. She’s worked through both Edition #2 and #3 of The PInk Kit so she knows all it’s imperfections and la-dee-dahs past them to the skills she wants to improve for each birth. Can women and men have better births each time? Sure can! The more skilled, the more we master the experience.
http://blog.naturalbirthandbabycare.com/pink-kit-timeline-from-natural-birth-and-baby-care-com/
Please join the Movement to grow a Skills-based childbirth trend. Don’t’ let another birth go by without that family being skilled.